椎管内肿瘤椎管切除术后感染影响因素及Th1/Th2细胞平衡的检测价值

Risk factors for infection after intraspinal tumors excision and the cilinical value of Th1/Th2 cell ratio detection

目的探讨椎管内肿瘤(IT)椎管切除术后感染影响因素及辅助性T细胞(Th)1/Th2细胞平衡的检测价值。方法选取2015年1月-2020年12月宁夏医科大学总医院收治的60例IT椎管切除术后感染患者为感染组,另选取同期医院收治的IT椎管切除术后未并发感染的患者60例为非感染组。收集纳入患者的临床资料,检测Th1/Th2细胞,采用受试者工作特征曲线(ROC)参数分析法分析Th1/Th2值对IT椎管切除术后感染的诊断价值;多因素Logistic回归分析法分析IT椎管切除术后感染的影响因素。结果感染组和非感染组患者在年龄、糖尿病史、肿瘤切除方式、手术时间方面比较,差异有统计学意义(P<0.05);但感染组患者的Th2指标高于非感染组,而Th1/Th2值低于非感染组,差异有统计学意义(P<0.05)。ROC曲线显示,将Th1/Th2值用于诊断IT椎管切除术后感染的AUC达0.876,临界值为1.66,灵敏度81.67%,特异性81.67%,95%CI为0.803~0.929。糖尿病史、分块切除、手术时间≥4 h是IT椎管切除术患者发生术后感染的影响因素(P<0.05)。结论IT椎管切除术后感染与多种因素有关,Th1/Th2检测对于诊断术后感染的发生具有积极意义。

OBJECTIVE To explore the risk factors for infection after intraspinal tumors(IT)excision and the clinical value of T helper cells(Th)1/Th2 ratio detection.METHODS A total of 60 patients with infection after IT excision admitted to the General Hospital of Ningxia Medical University between Jan 2015 and Dec 2020 were enrolled as the infection group,while other 60 patients without infection during the same period were enrolled as the non-infection group.The clinical data of enrolled patients were collected,and Th1/Th2 cell ratio was detected.The diagnostic value of Th1/Th2 cell ratio for infection after IT excision was explored by receiver operating characteristic(ROC)curves.The influencing factors for infection after IT excision were analyzed by multivariate Logistic regression analysis.RESULTS There were significant differences in age,diabetes history,tumor excision method and operation time between the infection group and non-infection group(P<0.05).Th2 cells in the infection group was significantly more than those in the non-infection group,while Th1/Th2 cell ratio was significantly lower than that in the non-infection group(P<0.05).ROC curve analysis showed that AUC,cut-off value,sensitivity,specificity and 95%CI of Th1/Th2 cell ratio for the diagnosis of infection after IT excision were 0.876,1.66,81.67%,81.67%and 0.803-0.929,respectively.Diabetes history,segmental excision and operation time≥4 h were influencing factors for the infection in patients after IT excision(P<0.05).CONCLUSION There are many influencing factors for the infection after IT excision.The detection of Th1/Th2 cell ratio is positively significant in the diagnosis of postoperative infection.